The effect of antiphospholipid antibodies on the frequency of extrasystoles in men with coronary heart disease and and myocardial infarction

Abstract

Abstract Background Coronary heart disease (CHD) is one of the most socially significant diseases of the cardiovascular system. Acute myocardial infarction (MI) develops 10 years earlier in men than in women. Manifestation of MI in young men quite often happen without clinically significant stenosis of coronary vessels. And fatal arrhythmias are one of the main causes of death in patient with cardiovascular diseases. Purpose To evaluate the clinical and pathogenetic significance of antiphospholipid antibodies (aPL) in patients with MI and disorders of rythm. Methods 107 patients men (average age 51.2 ± 6.15 years) with CHD and MI were examined. The content of aPL IgG - antibodies to cardiolipin, phosphatidylserine, phosphatidylinositol, phosphatidylacetate in the blood serum were determined by enzyme-linked immunosorbent assay and electrocardiography Holter monitor 24 hours tests were done. Results aPL IgG were detected in 56 patients (52,3% of the total number of patients with MI), it concentration threshold 10 GPL U/ml in blood serum. The median age of first acute MI in men 56 years, according to the literary data. In our investigation average age of aPL positive patients is 44.8 ± 5.47 years. They had first MI on average 12 years earlier than general population. The level of aPL IgG in blood serum was higher in 1,7 times (19,3 ± 7,32 GPL U/ml and 11,4 ± 5,41 GPL U/ml (p <0.05) in patients with recurrent MI compared to one MI. Also the results of the study showed that the highest prevalence of polytopic extrasystoles is observed among aPL positive CHD patients with recurrent MI (68,3%) compared to one MI in anamnesis (26,3%). Moreover, 23.2% of people who had recurrent MI had ventricular extrasystole of high gradations. It is important to note, that іn patients with first Q-MI levels of aFL IgG were in 1.27 times higher (p<0.05) than in patients with first non-Q-MI. And the frequency of the polytopic extrasystoles was on 38% higher (p<0.01) іn patients with first Q-MI compared to patients with first non-Q-MI. Conclusion The results obtained by us indicate the possible involvement of the autoimmune factor, in particular aPL IgG, in the pathogenesis of CHD. Positive correlation of aPL IgG with the frequency of rhythm disorders indicates the severity of condition in men with CHD and MI in anamnesis and need for further research.